Medicine and Health Sciences Commons^™

What Can Be Achieved With An Interprofessional Class?, Kitsum Li, Olivia Catolico

Kitsum Li

Introduction Recently, educators advocated for interprofessional education to better prepare entry-level healthcare workers for efficient, effective, and respectful teamwork to lower the cost of healthcare and improve the delivery of collaborative quality patient care. This article describes the results of an educational program evaluation of an interprofessional class (IPC) taught over a five-year period between nursing and occupational therapy (OT) departments at a small private university.

Methods During the IPC sessions, a small group of nursing and OT students observed a simulated patient care scenario in which a nursing and an OT student provided care related to their respective discipline. …

First-Time Experience In Owning A Dog Guide By Older Adults With Vision Loss, Kitsum Li, Jeffrey Kou, Yvonne Lam, Patricia Lyons, Susan Nguyen

Kitsum Li

Introduction: Dog guides were found to be effective in helping adults with vision loss navigate in the community and improve overall well-being. In spite of the vast amount of literature on pet therapy and dog companionship, limited study exists on older adult with vision loss experience of owning a dog guide. The purpose of this study is to explore the facilitators and barriers of first time owning and using a dog guide as experienced by older adults with vision loss.

Methods: Data were gathered among seven participants using open-ended semi-structured telephone interviews. Participants were asked to describe their experiences related …

An Innovative Behavioral Interview For Pre-Admission Selection Of Occupational Therapy Students, Kitsum Li, Julia L. Wilbarger, Shad St. Louis

Kitsum Li

The goal for pre-admission interview is to identify students who will be successful both academically and professionally. The traditional structured pre-admission interview has not been shown to be effective in predicting students’ success in academic and fieldwork performance. This article describes an innovative behavioral interview process during which applicants interviewed simulated clients as part of the preadmission selection process. The goals of the pre-admission behavioral interview were to observe applicants’ behavior as team players, and to assess their interpersonal communication skills, capability to be reflective, and professionalism. During the behavioral interview, faculty interviewers assessed the applicants’ performance in the planning …

Critically Appraised Paper For “The Effects Of A Home-Based Virtual Reality Rehabilitation Program On Balance Among Individuals With Parkinson’S Disease”, Amanda Lee, Sophie Miller, Holly Snyder, Phoebe Taasan, Kitsum Li

Kitsum Li

This study evaluated the effectiveness of a 12-week home-based exercise program using the Nintendo Wii system in its capacity to improve balance and balance confidence and maintain exercise compliance. Balance and balance confidence were measured with the Center of Pressure Length (COPL) and Activities-Specific Balance Confidence Scale (ABC), which were administered before the start of the intervention, 6 weeks into the intervention, and within 1 week postintervention. Although changes in balance and balance confidence scores were found to be nonsignificant, a pattern emerged in which scores for both measures rose between preand postintervention assessments, then fell to nearly baseline levels …

Critically Appraised Paper For “Efficacy Of Occupational Therapy For Patients With Parkinson's Disease: A Randomized Controlled Trial”, Amber Zadravecz, Hannah Tashjian, Emily White, Stephanie Pawek, Kitsum Li

Kitsum Li

Parkinson’s disease is a disabling, progressive condition that hinders occupational performance in daily activities and social participation. Occupational therapy supports engagement in activities that are meaningful to the patient. The purpose of this study was to explore the benefits of occupational therapy in addition to standard care for patients with Parkinson's disease.

Critically Appraised Paper For “Effect Of Physical Exercise-Movement Strategies Programme On Mobility, Falls, And Quality Of Life In Parkinson's Disease”, April Perez, Morganne Peterson, Raechel Jacala, Kitsum Li

Kitsum Li

A research team conducted a Level III prospective, longitudinal study to examine the effect of a standardized rehabilitation program, consisting of regular exercise and movement strategies, on fall risk, mobility, hospitalization, and quality of life for individuals with idiopathic Parkinson’s disease (PD). Over 2 years, 15 participants attended weekly rehabilitation sessions during Year 1 and biweekly sessions during Year 2. The rehabilitation program was designed to improve cardiovascular fitness, strength, flexibility, balance, posture, and gait pattern. Using a pre- and posttest study design, the research team assessed participants at baseline and at Year 1 and Year 2 follow-up evaluations. Using …

Critically Appraised Paper For “Cognitive Stimulation Of Executive Functions In Mild Cognitive Impairment: Specific Efficacy And Impact In Memory”, Avery Wilson, Yamin Zaw, Malcolm Isely, Kitsum Li

Kitsum Li

Executive functions play a pivotal role in an individual’s independence. However, little research has been conducted on the efficacy of specific cognitive training for individuals with deficits consistent with mild cognitive impairment (MCI). The researchers in this study aimed to use a cognitive stimulation program that taught specific strategies to enhance the participants’ attentional and executive functional tasks. The study, using a crossover design involving two groups, included 30 participants affected by the amnestic form of MCI, executive function deficits, or both. The 6-month training sessions addressed challenges through the use of individualized cognitive strategies and proposed activities to exercise …

Critically Appraised Paper For “Bobath Concept Versus Constraint-Induced Movement Therapy To Improve Arm Functional Recovery In Stroke Patients: A Randomized Controlled Trial.” Clinical Rehabilitation, Emily Garnica, Savannah Hancock, Tiffany Huang, Jessica Phung, Kitsum Li

Kitsum Li

The researchers used a Level I, single-blinded, randomized controlled trial design to compare the functional arm recovery of 22 high-functioning poststroke participants. Participants were evenly assigned to receive therapy using the Bobath concept or constraint-induced movement therapy (CIMT).

The first intervention group received therapy using the Bobath concept, a neurodevelopmental treatment focused on specific handling techniques that guide the patient’s affected arm through initiation and completion of tasks. The intervention consisted of 1 hr of training per day in an outpatient clinic and a 24-hr home program for 10 consecutive weekdays. The second intervention group received CIMT, a rehabilitation treatment …

In Adult Patients With Unilateral Stroke, Is Distributed Constraint-Induced Therapy Or Bilateral Arm Training More Effective In Improving Upper Extremity Motor And Functional Outcomes Compared With A Routine Approach?, Courtney Beyer, Christine Kim, Janice Li, Angelica Soltis, Kitsum Li

Kitsum Li

Stroke survivors may experience deficits and impairments of upper extremity (UE) function that limit their engagement in meaningful everyday occupations. It is important for occupational therapists to identify and test the effectiveness of interventions targeted to decrease UE learned nonuse, improve functional performance, and increase participation in one’s daily occupations. This study compared the efficacy of distributed constraint-induced therapy (dCIT) and bilateral arm training (BAT) in improving movement strategies and functional abilities of the UE in stroke survivors. Each intervention group participated in the intervention 2 hr/day, five times per week for 3 consecutive weeks. Participants in the dCIT group …

Critcally Appraised Paper For: “Is Modified Constraint-Induced Movement Therapy More Effective Than Bimanual Training In Improving Arm Motor Function In The Subacute Phase Post Stroke? A Randomized Controlled Trial.”, Jason Ichimaru, Jennifer Sik, Kelly Schmidt, Kitsum Li

Kitsum Li

Patients poststroke compose one of the largest demographics treated by occupational therapists in the physical disability setting. Approximately two-thirds of individuals who have had a stroke present with arm function impairment (Kwakkel & Kollen, 2007). Therefore, effective arm rehabilitation in occupational therapy settings is critical to help patients regain functional independence and quality of life. Modified constraint-induced movement (MCIM) therapy has been reported as the superior method of arm rehabilitation for individuals in the subacute phase poststroke, although recent research has also supported bimanual training. This 4-week, randomized controlled, quantitative study compared the effect of MCIM therapy and bimanual task-related …

For Stroke Patients, In What Ways Does Robot-Assisted Therapy Improve Upper Extremity Performance In The Areas Of Motor Impairment, Muscle Power, And Strength?, Maria Mandrussow, Ani Keshishyan, Kitsum Li

Kitsum Li

Stroke is the leading cause of long-term disability among adults. Adequate rehabilitation of the upper extremity in stroke patients can improve performance in activities of daily living. Robot-assisted therapy can offer intense, repetitive, and task-specific training to the impaired limb after stroke. Prior studies have shown that robot-assisted therapy may improve strength and motor deficits of the impaired limbs, but there is a lack of research comparing the effects of unilateral robot-assisted training protocol (URTP) versus bilateral robot-assisted training protocol (BRTP) with a robotic device. Comparison of the effectiveness of these two protocols is beneficial to determine the appropriate treatment …

Critically Appraised Paper For “The Effect Of Modified Constraint-Induced Movement Therapy On Spasticity And Motor Function Of The Affected Arm In Patients With Chronic Stroke.”, Jacqueline Bloom, Emily Lu, Matt Tong, Kitsum Li

Kitsum Li

This study explored the effect of modified constraint-induced movement therapy (CIMT) on the spasticity and functional use of the affected arm and hand among persons of working age who presented with spastic hemiplegia resulting from a stroke that occurred more than 6 months ago. The researchers developed a modified CIMT program for use in an outpatient rehabilitation clinic with intensive and varied exercise training aimed at targeting the negative symptoms of spastic hemiplegia. Previous research on CIMT has taken place in laboratory settings and has not specifically focused on CIMT’s effects on spasticity. The researchers used a battery of assessments …

Critically Appraised Paper For Occupational Therapy Intervention: Effects On Self-Care, Performance, Satisfaction, Self-Esteem/Self-Efficacy, And Role Functioning Of Older Hispanic Females With Arthritis, Jennifer Borcich, Erin Sheehy, Kitsum Li

Kitsum Li

Arthritis is a chronic condition that presents physical and psychosocial challenges that can affect daily functioning. The researchers in this study examined two frequently used methods of occupational therapy intervention—enabling or preparatory activities and occupation-based activities—for managing and improving symptoms of arthritis to improve participation, satisfaction, and self-efficacy in activities of daily living (ADLs). Twenty-nine older Hispanic women with osteoarthritis participated in the study and were randomized into two intervention groups and a control group. Whereas the occupation-based intervention group consisted of 10–15 min of enabling or preparatory activities, followed by 30 min of occupation-based activities, the enabling/preparatory-based intervention group …

Does Generalization Occur Following Computer-Based Cognitive Retraining?—An Exploratory Study, Kitsum Li, Jonathan Alonso, Nisha Chadha, Jennifer Pulido

Kitsum Li

Computer-based cognitive retraining (CBCR) intervention has gained great popularity in recent years. This study aimed to investigate the occurrence of skill generalization to daily living task for individuals with acquired brain injury (ABI) after completion of eight modules of a commercially available CBCR program, the Parrot Software. The study investigated changes in individuals’ global cognition as measured by the Montreal Cognitive Assessment, and changes in individuals’ performance during a medication-box sorting task, a novel instrumental activity of daily living. The medication-box sorting task resembled real life medication management with daily prescribed and over-the-counter medications. Twelve individuals with ABI from a …

Mild Cognitive Impairment In Heart Failure Affects Care Transition, Kitsum Li, Kristin Myers

Kitsum Li

Objectives After attending the presentation, the audiences will be able to: Understand the importance of cognition in everyday activity and the cognitive hierarchy to guide practice. Recognize the incidence of mild cognitive impairment in individuals with heart failure. Understand how mild cognitive impairment may affect heart failure self- care practice and hospitalization readmission. Identify the evidence that support use of cognitive screen to identify mild cognitive impairment in individuals with heart failure. Compare the evidence among three cognitive screens (Mini-mental Status Exam, Montreal Cognitive Assessment and St. Louis University Mental State Exam). (Using Montreal Cognitive Assessment as an example)Identify cognitive …

A Transformative Experience For Occupational Therapy Students In A Simulated Learning Environment, Kitsum Li, Barbara Mccamish

Kitsum Li

Simulation is being integrated into nursing and medical curriculum nationally and it is well integrated into the Nursing program at Dominican University of California, However, use of simulation in allied health professionals is only an emerging practice. The aim of this program is to integrate simulation into the OT curriculum in order to facilitate the development of therapy foundation skill.

Clinical Reasoning In The Use Of Slings For Patients With Shoulder Subluxation After Stroke: A Glimpse Of The Practice Phenomenon In California, Kitsum Li, Naoko Murai, Simon Chi

Kitsum Li

Literature reports the frequent use of shoulder slings by occupational therapists for the management of post-stroke shoulder subluxation despite the low evidence for its efficacy. To understand the clinical context that defies current research evidence, a survey was distributed among California occupational therapists. One hundred and sixty-eight participants responded to the survey, answering questions regarding the occurrences and clinical reasoning in the use of shoulder sling with patients post stroke. 81.5% of the respondents reported the use of shoulder sling. However, the actual sling prescription was limited to 28.4% of their patients. Slings were primarily prescribed for upper extremity management …

Computer-Based Cognitive Retraining For Adults With Chronic Acquired Brain Injury: A Pilot Study, Kitsum Li, Julie Robertson, Joshua Ramos, Stephanie Gella

Kitsum Li

This study evaluated the effectiveness of a computer-based cognitive retraining (CBCR) program on improving memory and attention deficits in individuals with a chronic acquired brain injury (ABI). Twelve adults with a chronic ABI demonstrating deficits in memory and attention were recruited from a convenience sample from the community. Using a quasi-experimental one-group pretest–posttest design, a significant improvement was found in both memory and attention scores postintervention using the cognitive screening tool. This study supported the effectiveness of CBCR programs in improving cognitive deficits in memory and attention in individuals with chronic ABI. Further research is recommended to validate these findings …

Does Therapeutic Horseback Riding Decrease Balance Deficits In Community-Dwelling Older Adults?, Salwa Yaser, Lisa Mrsny, Krystin Beeman, Skyler Moon, Kitsum Li

Kitsum Li

Hippotherapy and therapeutic riding (TR) provide pleasurable activity and physical exercise to individuals and yet limited study is available on its therapeutic value to improve balance in older adults. In this study, the researchers measured the benefit of TR on balance and quality of life in communitydwelling older adults. A convenience sample of individuals 65 years and older was recruited from a local community. The study is a single-blind, pretest-posttest, controlled study of a 10-session TR program with a Professional Association of Therapeutic Horsemanship (PATH) trained and certified TR instructor. Each TR session included grooming and tacking, mounting, a warm-up …

Clinical Reasoning In The Use Of Slings For Patients With Shoulder Subluxation After Stroke: A Glimpse Of The Practice Phenomenon In California, Kitsum Li, Naoko Murai, Simon Chi

Kitsum Li

Literature reports the frequent use of shoulder slings by occupational therapists for the management of post-stroke shoulder subluxation despite the low evidence for its efficacy. To understand the clinical context that defies current research evidence, a survey was distributed among California occupational therapists. One hundred and sixty-eight participants responded to the survey, answering questions regarding the occurrences and clinical reasoning in the use of shoulder sling with patients post stroke. 81.5% of the respondents reported the use of shoulder sling. However, the actual sling prescription was limited to 28.4% of their patients. Slings were primarily prescribed for upper extremity management …

Does Therapeutic Horseback Riding Decrease Balance Deficits In Community-Dwelling Older Adults?, Salwa Yaser, Lisa Mrsny, Krystin Beeman, Skyler Moon, Kitsum Li

Kitsum Li

Hippotherapy and therapeutic riding (TR) provide pleasurable activity and physical exercise to individuals and yet limited study is available on its therapeutic value to improve balance in older adults. In this study, the researchers measured the benefit of TR on balance and quality of life in communitydwelling older adults. A convenience sample of individuals 65 years and older was recruited from a local community. The study is a single-blind, pretest-posttest, controlled study of a 10-session TR program with a Professional Association of Therapeutic Horsemanship (PATH) trained and certified TR instructor. Each TR session included grooming and tacking, mounting, a warm-up …

Computer-Based Cognitive Retraining For Adults With Chronic Acquired Brain Injury: A Pilot Study, Kitsum Li, Julie Robertson, Joshua Ramos, Stephanie Gella

Kitsum Li

This study evaluated the effectiveness of a computer-based cognitive retraining (CBCR) program on improving memory and attention deficits in individuals with a chronic acquired brain injury (ABI). Twelve adults with a chronic ABI demonstrating deficits in memory and attention were recruited from a convenience sample from the community. Using a quasi-experimental one-group pretest–posttest design, a significant improvement was found in both memory and attention scores postintervention using the cognitive screening tool. This study supported the effectiveness of CBCR programs in improving cognitive deficits in memory and attention in individuals with chronic ABI. Further research is recommended to validate these findings …

Does Therapeutic Horseback Riding Decrease Balance Deficits In Community-Dwelling Older Adults?, Salwa Yaser, Lisa Mrsny, Krystin Beeman, Skyler Moon, Kitsum Li

Kitsum Li

Hippotherapy and therapeutic riding (TR) provide pleasurable activity and physical exercise to individuals and yet limited study is available on its therapeutic value to improve balance in older adults. In this study, the researchers measured the benefit of TR on balance and quality of life in communitydwelling older adults. A convenience sample of individuals 65 years and older was recruited from a local community. The study is a single-blind, pretest-posttest, controlled study of a 10-session TR program with a Professional Association of Therapeutic Horsemanship (PATH) trained and certified TR instructor. Each TR session included grooming and tacking, mounting, a warm-up …

Clinical Reasoning In The Use Of Slings For Patients With Shoulder Subluxation After Stroke: A Glimpse Of The Practice Phenomenon In California, Kitsum Li, Naoko Murai, Simon Chi

Kitsum Li

Literature reports the frequent use of shoulder slings by occupational therapists for the management of post-stroke shoulder subluxation despite the low evidence for its efficacy. To understand the clinical context that defies current research evidence, a survey was distributed among California occupational therapists. One hundred and sixty-eight participants responded to the survey, answering questions regarding the occurrences and clinical reasoning in the use of shoulder sling with patients post stroke. 81.5% of the respondents reported the use of shoulder sling. However, the actual sling prescription was limited to 28.4% of their patients. Slings were primarily prescribed for upper extremity management …

Computer-Based Cognitive Retraining For Adults With Chronic Acquired Brain Injury: A Pilot Study, Kitsum Li, Julie Robertson, Joshua Ramos, Stephanie Gella

Kitsum Li

This study evaluated the effectiveness of a computer-based cognitive retraining (CBCR) program on improving memory and attention deficits in individuals with a chronic acquired brain injury (ABI). Twelve adults with a chronic ABI demonstrating deficits in memory and attention were recruited from a convenience sample from the community. Using a quasi-experimental one-group pretest–posttest design, a significant improvement was found in both memory and attention scores postintervention using the cognitive screening tool. This study supported the effectiveness of CBCR programs in improving cognitive deficits in memory and attention in individuals with chronic ABI. Further research is recommended to validate these findings …

For Low-Income Adults Who Experience Trouble With One Or More Activities Of Daily Living (Adl) Or Two Or More Instrumental Activities Of Daily Living (Iadl), Does The Community Aging In Place: Advancing Better Living For Elders (Capable) Improve Performance Of Adls And Iadls?, Noelle Bakken, Lauryn Banovitz, Abigail Lafrenz, Kitsum Li

Kitsum Li

The growing population of older adults has created a societal shift, with many older adults preferring to stay in their homes for a longer period of time. This trend, known as aging-inplace, may provide greater independence and autonomy to older adults compared with those living in nursing homes. However, physical and cognitive changes associated with age may affect the ability to safely perform activities of daily living (ADL) and instrumental activities of daily living (IADL). This study examined performance in ADLs and IADLs, fall efficacy, and quality of life in 40 low-income, community dwelling adults aged 65 and older. Participants …

Do Restorative Home Care Programs Increase Independence In Adls And Iadls In Older Adults Receiving Home Health Services?, Adrienne Angeles, Shanee Ben-Haim, Amy Smith-Schwartz, Kitsum Li

Kitsum Li

There has been a worldwide shift from viewing aging as a dependent stage of life to one that increasingly encourages independence and a more active lifestyle for older adults. In Australia, where this study was conducted, restorative care that embraces active aging was not yet considered an essential component of home health care on the national level. However, restorative home care has been gaining more recognition as increasing importance is placed on independence and self-management in older adults. The researchers of this study explored whether older adults’ participation in restorative home care programs reduced the need for ongoing personal care. …

Does A Multicomponent Home Intervention Reduce Functional Difficulties In Community-Dwelling Older Adults As Compared To No Intervention?, Laura Henty-Clark, Rosemarie Lion, Nadine Marcelo, Kitsum Li

Kitsum Li

Many older adults live with chronic conditions that may affect their ability to safely perform their daily occupations. Small decreases in ability of older adults to function independently can have profound effects, possibly leading to hospitalization, institutionalization, or death. However, preventative home-based interventions for older adults typically are not reimbursed by Medicare or other insurance carriers. This study on intervention effectiveness contributes to a growing body of evidence for providing preventative home-based intervention to older adults to support their abilities to function independently in their communities. This study examined whether a preventative home-based intervention, including occupational therapy and physical therapy, …

For Healthy Older Adults, Does Participation In A Water-Based Balance Training Exercise Program, When Compared To A Land-Based Balance Training Exercise Program, Improve Balance Performance?, Sara Pro, Rajvinder Bains, Kitsum Li

Kitsum Li

Occupational therapy plays a significant role in wellness promotion for older adults. Critical to maintaining health and wellness in older adults is prevention of falls and fall-related injuries. One in three community-dwelling older adults reports a fall every year, and the incidence of falls increases exponentially from ages 60 to 65 and 80 to 85. Falls are associated with increased morbidity and mortality from fractures and secondary complications. Leading causes of falls in older adults include decreased balance and an abnormal gait pattern. Balance training programs can help improve balance, decrease the risk of falling, and promote functional independence. However, …

For Patients With Acute Cerebral Vascular Accident, Is Virtual Reality Gaming More Effective Than Standard Recreational Therapy For The Improvement Of Hand Function?, Amy Marie Sequeira Boeschen, Elizabeth Jeanne Szoboszlay, Martha Welderufael, Kitsum Li

Kitsum Li

To evaluate the safety, feasibility, and efficacy of VR gaming using the Nintendo Wii vs. standard recreational therapy for the improvement of UE function in patients who have experienced a stroke.